Medical Assistance in Dying: A Compromise is Better than No Law at All

In February 2015 the Supreme Court of Canada struck down the existing laws on euthanasia and assisted suicide and gave the Federal Government a deadline to replace those laws. That deadline expires on June 6, 2016. Since the change in government there has been intensive study and debate on these issues that have culminated in the release of Bill C-14. Since late April, Members of Parliament have been reflecting on this bill and making a decision—and the the House of Commons will consider final amendments to the bill this week.

In Bill C-14 the Government is addressing the Supreme Court requirements (to make assisted death legal in Canada) in a measured way, by proposing strict limits on access to medically assisted death. This legislation is by no means perfect, but it provides a first step to avoiding a dangerous legal vacuum (i.e. no restrictions on assisted death) that would result if no law is passed by June 6. In recent letters to the government the Centre for Public Dialogue has argued that if medically assisted death must be a legal reality, legislation and policy should:
• protect vulnerable people from involuntary euthanasia;
• protect the conscience rights of medical care providers and institutions;
• be subject to careful tracking and legislative review;
• and enhance palliative care options

Bill C-14 provisions that we’re watching:
• As it stands Bill C-14 does not make clear provisions for conscience protection for medical care
providers and institutions. It leaves these protections to ‘non-legislative’ measures that are to
come through discussion and regulation with medical associations and provinces. We will be
asking for clearer legislative provisions for conscience protection.
• C-14 restricts eligibility for assisted death to people who are near the end of life. This is a stronger restriction than more permissive ideas floated by a Parliamentary Committee earlier this year (i.e. access for ‘mature minors’ and persons with mental illness).
• The provisions for informed consent in the Bill provide protections for vulnerable people.
Disability advocates argue that these provisions should be strengthened with clear commitments to screening for vulnerability to outside influence favouring assisted death.
• Bill C-14 makes provisions for the collection of data on assisted death and a 5-year review of the legislation. Thoughtful tracking and analysis of this data will reveal the legal and ethical challenges that are likely to emerge, challenges which can be addressed in robust public dialogue in the review period.

The danger we see in this rushed legislative process is that our assisted dying laws in Canada end up in the same state that our abortion laws did: non-existent. Our inability to agree on abortion legislation in the late 1980s and early 1990s—the polarization of the political debate—left us with no legislation at all. In fact, both pro-life and pro-choice (though I hesitate to use those terms because they oversimplify and further polarize the debate) groups fought to defeat the proposed abortion legislation in the Senate! With the 20-20 vision of hindsight we can say that the all-or-nothing stance by many in the pro-life movement was deeply counterproductive to the cause. Would have a position of legal, safe and rare abortion been a more proximate strategy to protect at least some life? Perhaps.

If we can’t come to a reasonable consensus on this legislation by June 6, there will effectively be no law at all in Canada against assisted dying. It will be entirely unregulated.

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